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Cited by 244Oral microbiology and periodontitis researchGut microbiota and healthDental Research and COVID-19

From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease.

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Kumar, Purnima S.·2017·The Journal of Physiology
DOI 10.1113/jp272427PMC PMC5233655
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Abstract

The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and metabolic disease. It was proposed that periodontal pathobionts played a causal role in the initiating or exacerbating certain diseases either by direct invasion or by stimulating a florid immune-inflammatory response that extended into the systemic circulation. This review will examine the strength of current evidence in establishing a causal link between oral pathobionts and systemic disease.

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  • Periodontal pathogens such as Treponema denticola, P. gingivalis, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and Veillonella parvula have been detected in the lungs of ICU patients.

    “Periodontal pathogens such as Treponema denticola, P. gingivalis, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans and Veillonella parvula, have been detected in the lungs of ICU patients (Kumar, 2017; de Carvalho Baptista et al., 2018).”

    From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Kumar, 2017

  • Poor oral hygiene habits can lead to the accumulation of many periodontal microorganisms in the oral cavity, and oral dysbiosis can accelerate lung function decline, which in turn can increase the incidence of pneumonia.

    “Poor oral hygiene habits can lead to the accumulation of many periodontal microorganisms in the oral cavity, and oral dysbiosis can accelerate lung function decline (Takeuchi et al., 2018; Winning et al., 2019), which in turn can increase the incidence of pneumonia (Kumar, 2017).”

    From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Kumar, 2017

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Research works printed but not linked: 4

  1. Hartzell TB & Henrici AT (1916). The dental path: Its importance as an avenue to infection. Public Health J 7, 254–259. [Google Scholar]
  2. Ingle JI, Bakland LK & Baumgartner JC (2008). Ingle's Endodontics 6 BC Decker, Hamilton, Ontario. [Google Scholar]
  3. Loesche WJ (1982). Dental Caries: A Treatable Infection. Charles C. Thomas, Springfield, IL. [Google Scholar]
  4. Toews GB ( 1986). Nosocomial pneumonia. Am J Med Sci 291, 355–367. [DOI] [PubMed] [Google Scholar]

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Authors
Kumar, P. S.
Affiliations
The Ohio State University (US)
Corresponding author
Kumar, Purnima S.
ORCID
Kumar, Purnima S.
Venue
The Journal of Physiology
Publisher
Wiley
Published
2016-08-28
Volume
595
Issue
2
Pages
465-476
ISSN
  • 0022-3751 (ISSN-L)
  • 1469-7793
DOI
10.1113/jp272427
PMC
PMC5233655
OpenAlex
W2491787181
Cited by
241
References
123
Citations by year
2026: 9 · 2025: 16 · 2024: 33 · 2023: 29 · 2022: 33 · 2021: 44 · 2020: 37 · 2019: 18 · 2018: 12 · 2017: 7 · 2016: 3
FWCI
2.32
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • The Journal of Physiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Dental and Craniofacial Research (R01‐DE022579)
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
Keywords
oral microbiota, periodontal medicine, focal infection theory, periodontitis, systemic disease, oral pathobionts, dysbiosis, cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, preterm birth, low birth weight, dental caries, root canal infection, host immune response
MeSH terms
Humans, Mouth, Periodontal Diseases, Periodontics, Sepsis, Microbiota

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